Evidence map›Paper›PMID 41137621›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025

Cardiovascular disease as a mediator in the relationship between lifestyle risk factors and cognitive outcomes: a scoping review.

Abby L J Hensel, Therese Chan, Raisa Ahmed, Prabasha Rasaputra, Becky Skidmore, Hao Luo, Davide Liborio Vetrano, Jodi D Edwards, Jacob Crawshaw, Monica Parry and 13 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Abby L J HenselBruyère Health Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0003-2944-6754
Therese ChanBruyère Health Research Institute, Ottawa, Ontario, Canada.
Raisa AhmedBruyère Health Research Institute, Ottawa, Ontario, Canada.
Prabasha RasaputraBruyère Health Research Institute, Ottawa, Ontario, Canada.
Becky SkidmoreIndependent Information Specialist, Ottawa, Ontario, Canada.
Hao LuoSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Davide Liborio VetranoDepartment of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institute and Stockholm University, Solna, Sweden.
Jodi D EdwardsBruyère Health Research Institute, Ottawa, Ontario, Canada.
Jacob CrawshawThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Monica ParryLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Frank KnoefelBruyère Health Research Institute, Ottawa, Ontario, Canada.
Yan XuFaculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Sandra MagalhaesDepartment of Sociology, University of New Brunswick, Fredericton, NB, Canada.
Wallis C Y LauResearch Department of Practice and Policy, University College London School of Pharmacy, London, UK.
Stacey FisherThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Ann-Marie JulienBruyère Health Research Institute, Ottawa, Ontario, Canada.
Linda HunterBruyère Health Research Institute, Ottawa, Ontario, Canada.
Kathryn A BezzinaBruyère Health Research Institute, Ottawa, Ontario, Canada.
Kevin E BoczarUniversity of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Douglas G ManuelThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Andrew R FrankBruyère Health Research Institute, Ottawa, Ontario, Canada.
Kednapa ThavornSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Amy HsuBruyère Health Research Institute, Ottawa, Ontario, Canada.

Funding

Canada First Research Excellence Fund for the Brain-Heart Interconnectome CFREF-2022-00007Canadian Institutes of Health Research for the Canadian Consortium on Neurodegeneration in Aging CNR-203502
6 · The paper itself

Abstract

Dementia is a major global health challenge and lifestyle modification is a key prevention strategy. Cardiovascular disease (CVD) is hypothesized to mediate lifestyle-dementia relationships, but empirical evidence is unclear. Mediation analysis offers insight into causal mechanisms beyond traditional associations. This scoping review synthesizes the limited available studies applying mediation analysis to examine whether CVD mediates associations between lifestyle factors (smoking, alcohol use, diet, physical activity) and cognitive outcomes in adults aged 45 and older. Of 1309 records screened, five studies met the inclusion criteria, reflecting a small, heterogeneous evidence base. Most examined physical activity (n = 4), with two reporting partial mediation by composite CVD risk scores. Evidence for diet (n = 2) and alcohol (n = 1) was inconclusive, and no studies assessed smoking. Overall, evidence for CVD as a mediator remains tentative, sparse, and inconsistent, highlighting major methodological gaps and an urgent need for robust studies to clarify whether cardiovascular health underpins lifestyle-related dementia risk. HIGHLIGHTS: Five studies were identified that used mediation analysis to explore the role of cardiovascular disease in the relationship between lifestyle risk factors and dementia. Cardiovascular disease may partially mediate the impact of physical activity on brain health. Diet and alcohol consumption showed no clear mediation effects by cardiovascular disease on cognition. Longitudinal, well-powered studies with robust mediation frameworks are urgently needed to evaluate vascular pathways and optimize dementia prevention strategies targeting modifiable lifestyle factors.

Indexed as

Cardiovascular DiseasesCognitionDementiaLife StyleAgedAlcohol DrinkingDietExerciseHumansMiddle AgedRisk Factorsagingcardiovascular diseasesdementiamediation analysisrisk factors

Identifiers

PMID41137621
PMCPMC12552895

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.